Cancer survivorship: Reproductive health outcomes should be included in standard toxicity assessments.

It is well established that cancer and its treatment, whether by chemotherapy, radiotherapy, hormone therapy, or surgery, can adversely impact reproductive function in both women and men. The effects of cancer treatment on reproductive function in both sexes may lead to loss of fertility, sexual desire and function, and hormone deficiency, which results in additional long-term morbidity in more than a third of patients. Given the importance of reproductive function to most people, and the often devastating effect of cancer treatment on it, we propose that proactive assessment of the functional and endocrinological impact of treatment be made a vital component of the assessment of modern cancer treatment, and should be a routine part of discussions with patients before and after treatment, both in trials and in routine care. Reproductive counselling should be proactive and encouraged, as implementation of such counselling has been shown to be beneficial to patient mental health, quality of life, and adherence to treatment. Similarly, efforts should be made to provide more adequate and accurate information to patients, as well as to offer appropriate fertility preservation approaches, which may potentially influence their treatment decisions.

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Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest statement D.C. reports no financial competing interests. D.C. reports participating in an advisory board for, and acting as a consultant for, Roche Diagnostics. Both positions involved reimbursement to his employer. FC. reports receiving honoraria from AstraZeneca, BMS, Lilly, Merck and Roche Diagnostics, and his institution receiving research funding from Roche Diagnostics and AstraZeneca. F.P. reports receiving honoraria in the last three years from AstraZeneca, Ipsen and Roche Diagnostics. I.D. reports acting as a consultant for Roche Diagnostics, and receiving speaker honoraria from Novartis. I.D. reports receiving support for congress participation from Ferring and Theramex. M.L. reports acting as a consultant for Novartis, Roche and AstraZeneca, and receiving honoraria from Theramex, Roche, Novartis, Pfizer, Takeda and Lilly. R.A.A. reports acting as a consultant for Roche Diagnostics, IBSA, Merck, Ferring, NeRRE Therapeutics and Sojournix Inc. S.M.N. reports participating in advisory boards and receiving speaker or consultancy fees from Access Fertility, Beckman Coulter, Ferring, Finox, Merck, MSD, Roche Diagnostics and The Fertility Partnership. S.M.N. reports receiving grant funding from government, charity and industry funders, including Roche Diagnostics and Ferring Pharmaceuticals. A.M. reports no competing interests.